Reversible ectopic soft tissue ossification following measles encephalomyelitis.

For many years it has been recognized that changes may take place in the skeletal bony and soft tissues in paraplegic patients. Madame Dejerine and her co-workers described such changes in 1918 and 1919 (Dejerine and Ceillier, 1918; D1jerine, Ceillier and Dejerine, 1919). War injuries, road and industrial accidents have been responsible for an increased number of paraplegic patients, many of whom are young and otherwise healthy. The increasing use of radiography has also contributed to our assessment of the problem. Lodge (1956) has written a valuable paper on the subject based on his review of x-ray findings in 236 paraplegic subjects. The pathogenesis of the condition remains a mystery. Clinically the lesion occurs in patients suffering a spinal cord lesion with paraplegia in flexion leading to muscle spasm. Recumbency, promoting the mobilization of calcium from the bones, is probably a factor. Paraplegia in childhood is a relatively uncommon condition and there are few instances reported of soft tissue ossification accompanying paraplegia in childhood. No less an authority than Caffey (1961) has stated that he has not seen these soft tissue changes in children suffering from paraplegia. Lorber (1953) has reported the condition as a complication of the paraplegia associated with tuberculous meningitis treated with streptomycin. It is the purpose of this paper to record the history of a child who developed ectopic ossification round the hips following paraplegia secondary to measles encephalomyelitis, and to report that almost complete recovery from the lesions ensued. This is the first known report of this condition arising as a complication of measles.